Nokea
The emergency department (ED) nurse cares for a client who reports persistent nausea and vomiting for three days. Which acid-base imbalance would the nurse expect based on the client's manifestations?
- A. A decreased pH and an elevated CO2
- B. An elevated pH and a decreased CO2
- C. A decreased pH and a decreased HCO3-
- D. An increased pH with an increased HCO3-
Correct Answer: D
Rationale: Persistent vomiting causes loss of gastric acid, increasing HCO3- and pH, leading to metabolic alkalosis (D).
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The nurse is reviewing a client's arterial blood gas (ABG) results who has a nasogastric tube (NGT) attached to continuous suction. The ABG results reveal the following: pH 7.50 [7.35-7.45], PaCO2 42 mmHg [35-45 mm Hg], HCO3- 35 mEq/L [22-28 mEq/L]. The nurse should interpret these results to indicate that the client has
- A. respiratory acidosis
- B. respiratory alkalosis
- C. metabolic acidosis
- D. metabolic alkalosis
Correct Answer: D
Rationale: High pH (7.50) and elevated HCO3- (35 mEq/L) with normal PaCO2 indicate metabolic alkalosis (D), likely due to loss of gastric acid from NGT suction.
The nurse reviews a client's arterial blood gas results. Based on the results, the nurse plans to obtain a physician's order to Laboratory: pH 7.33 [7.35-7.45], PaCO2 39 mm Hg [35-45 mm Hg], HCO3 24 mEq/L [22-28 mEq/L], PaO2 72 mm Hg [80-100 mm Hg]
- A. administer supplemental oxygen
- B. administer a benzodiazepine
- C. administer sodium bicarbonate intravenously
- D. reassess the ABG in two hours
Correct Answer: A
Rationale: The ABG shows normal pH and PaCO2 but low PaO2 (72 mm Hg), indicating hypoxemia. Supplemental oxygen (A) is needed. Benzodiazepines (B) are irrelevant, sodium bicarbonate (C) is for acidosis, and reassessing (D) delays treatment.
The nurse is working in the emergency department caring for a client with diabetic ketoacidosis (DKA). Which of the following arterial blood gas (ABG) results would be expected?
- A. pH = 7.50 [7.35-7.45]; PaO2 = 90 mm Hg [80-100 mm Hg]; PaCO2 = 37 mm Hg [35-45 mm Hg]; HCO3- = 31 mEq/L [22-28 mEq/L]
- B. pH = 7.31 [7.35-7.45]; PaO2 = 90 mm Hg [80-100 mm Hg]; PaCO2 = 56 mm Hg [35-45 mm Hg]; HCO3- = 23 mEq/L [22-28 mEq/L]
- C. pH = 7.51 [7.35-7.45]; PaO2 = 94 mm Hg [80-100 mm Hg]; PaCO2 = 31 mm Hg [35-45 mm Hg]; HCO3- = 24 mEq/L [22-28 mEq/L]
- D. pH = 7.31 [7.35-7.45]; PaO2 = 90 mm Hg [80-100 mm Hg]; PaCO2 = 37 mm Hg [35-45 mm Hg]; HCO3- = 15 mEq/L [22-28 mEq/L]
Correct Answer: D
Rationale: DKA causes metabolic acidosis due to ketone accumulation, lowering pH and HCO3-. Option D (pH 7.31, HCO3- 15 mEq/L) reflects uncompensated metabolic acidosis. Options A and C show alkalosis, and B shows respiratory acidosis.
Which of the following abnormalities in the arterial blood gas (ABG) would be consistent with a client who has overdosed on clonazepam?
- A. metabolic acidosis
- B. metabolic alkalosis, fully compensated
- C. respiratory alkalosis
- D. respiratory acidosis
Correct Answer: D
Rationale: Clonazepam, a benzodiazepine, depresses the central nervous system, reducing respiratory drive and causing CO2 retention, leading to respiratory acidosis (D). Metabolic acidosis (A), metabolic alkalosis (B), and respiratory alkalosis (C) are not typical.
The nurse interprets this ABG result as Laboratory: pH 7.59 [7.35-7.45], PaCO2 30 mmHg [35-45 mm Hg], HCO3- 24 mEq/L [22-28 mEq/L], PaO2 85 mmHg [80-100 mm Hg]
- A. Metabolic acidosis
- B. Respiratory acidosis
- C. Metabolic alkalosis
- D. Respiratory alkalosis
Correct Answer: D
Rationale: High pH (7.59) and low PaCO2 (30 mm Hg) with normal HCO3- indicate uncompensated respiratory alkalosis (D).